Multicenter prospective study of survival and quality of life after first diagnosis of brain metastasis
Dr. Olav Erich Yri
A major concern in anticancer treatment (ACT) of brain metastases (BMs) is exposing patients with short expected survival to treatments that negatively impact quality of life (QOL). Such futile ACT at the end of life is time-consuming and burdensome for patients and their families and entails unnecessary health care costs. A multicenter prospective study in Norway provides real-life data on survival after BM diagnosis and patient-reported outcomes after ACT to identify risk factors for futile treatment. The study included 912 patients with a first BM diagnosis from November 2017 to March 2021, with follow-up until death or study end (October 1st, 2023). For the total cohort, median overall survival after BM diagnosis was 5.9 months (95% CI 5.2-6.7). EOCG performance status >1, uncontrolled extracranial metastases, and ≥ 5 BMs were associated with shorter survival. Patients surviving <6 months after BM diagnosis reported worse QOL scores two months after ACT; patients surviving ≥ 6 months reported stable scores over time. The authors conclude that patients with ECOG performance status >1 are at risk for futile ACT.